The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
COMMISSIONER
DANIEL E. WALL
EXECUTIVE
DEPUTY COMISSIONER
NY96-05
PE96-02
PA96-01
TO: NY, PA, PE Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Changes in MetraHealth's 800 number
DATE: February 7, 1996
During the past year, MetraHealth has succeeded in virtually eliminating any blockage (busy signals) on their 800 line for Empire Plan enrollees and providers: 1-800-942-4640. Over the past several months the number of blocked calls has been averaging less than 1%. In light of that success, in December 1995 we authorized MetraHealth to reduce the phone service hours slightly. The hours are now 8:00 a.m. to 4:30 p.m. Monday through Friday. This change will lead to substantial cost savings for the Plan without adversely affecting service to enrollees and administrators.
Given the improvement in service on the primary 800 line and the very low volume of calls on the 800 line dedicated to HBAs (1-800-654-4778), we have also authorized MetraHealth to eliminate the HBA line effective March 1, 1996, as another cost savings measure. After March 1, you must use the 1-800-942-4640 number to contact MetraHealth. In order to reach a representative quickly, follow the instructions for rotary phone callers and just stay on the line when you hear the first message. That will allow you to bypass the Interactive Voice Response System (IVR), and your call will be routed immediately to a representative on the geographic team serving the area you are calling from. The claims office staff has been reorganized into geographic teams which, as the result of their familiarity with the agencies, providers and enrollee population in their area, will be better able to meet your needs. Each Customer Service Representative in a team can answer your questions and help to resolve problems regarding Metropolitan benefits and claims.
The instructions for bypassing the IVR are for Health Benefits Administrators only. Please don't share them with enrollees.
If you choose to use the IVR, you can follow the menu to contact Managed Physical Network (MPN) or the Home Care Advocacy Program (HCAP), request a provider listing, order claim forms or obtain information such as the status of an enrollee's claims.
If you need to contact MetraHealth before March 1, we encourage you to use the 1-800-942-4640 number so that you can begin working with the team that services your area. Thank you for your cooperation.